Black, Hispanic individuals up to 30% less likely to receive post-stroke treatment

Black and Hispanic patients were less likely to be treated for stroke complications than their white counterparts, particularly treatment of arousal, spasticity and mood, per data presented at the International Stroke Conference.

“A constellation of symptoms may manifest after a stroke; however, not all complications are life-threatening events,” Kent P. Simmonds, DO, PhD, lead author of the study and resident in physical medicine and rehabilitation at the University of Texas Southwestern Medical Center, said in a related press release. “Some complications may be more subtle and go undetected by the medical community and, as a result, people from different racial or ethnic groups may not receive equitable treatment.”

Simmonds and colleagues sought to quantify the magnitude and timing of differences in treatment of post-stroke complications by race to better inform and improve response in clinical practice.

They accessed data from electronic medical records of 65 health care organizations from 2002 to 2022 to identify a diverse cohort of hospitalized acute stroke patients. The final group comprised more than 428,000 individuals and included patients who identified as non-Hispanic white (n = 309,029), Black (n = 82,564) and Hispanic (n = 28,375).

Researchers adjusted for baseline differences between groups based on 41 demographic and clinical factors, including age, sex and other health conditions, and matched 80,564 pairs for the non-Hispanic white/Black comparison and 28,375 pairs for the non-Hispanic white/Hispanic comparison.

The analysis included medication use for treatment of central nervous system arousal or fatigue, spasticity, mood, sleep, bladder dysfunction and seizure. Differences were measured at 14, 90 and 365 days.

Compared with non-Hispanic white patients, Black patients were significantly less likely to be treated for their symptoms at almost every timepoint, with the greatest differences in treatment of arousal (RR = 0.7; 95% CI, 0.66-0.74), spasticity (RR = 0.73; 95% CI, 0.71-0.76) and mood (RR = 0.83; 95% CI, 0.82-0.85) at the 14-day checkpoint, according to study results.

Black patients were 30% less likely than white patients to receive treatment for central nervous system arousal, 27% less likely for spasticity and 17% less likely for mood irregularities, according to the press release.

Differences in treatment of those symptoms in the non-Hispanic white/Hispanic comparison were similar but not as significant at 20%, 19% and 16%, respectively.

”We found that the disparities among different population groups narrowed a little over time, and this likely shows that some of these conditions are being recognized and treated,” Simmonds said in the release. “However, even at the 1-year mark, the overall treatment disparities remain for the treatment of nearly all post-stroke complications.”

Reference:

• Black and Hispanic people in U.S. less likely to get treatment for stroke complications. https://newsroom.heart.org/news/black-and-hispanic-people-in-u-s-less-likely-to-get-treatment-for-stroke-complications?preview=6c45. Published Feb. 2, 2023. Accessed Feb. 8, 2023.